Telegraph: Patients may be guilty of discrimination if they refuse care of transgender medic, NHS bosses told

[ResisterRex]

A report by the NHS confederation is in today's Telegraph. A good example of how a hierarchy of EDI seems to have been cultivated, with disabled people right at the bottom. Anyone who's had a parent or grandparent with dementia will be upset to read that parts of the NHS want to be able to refuse to provide care to their loved one because their comfort comes last.

www.telegraph.co.uk/news/2023/06/09/nhs-patients-discrimination-transgender-staff/

"Patients may be found guilty of discrimination if they refuse the care of a transgender medicc_, according to new NHS guidance.
Health bosses have been warned that patients have no right to be told a healthcare worker’s assigned sex at birth.
However, transgender health workers can choose not to treat patients if they feel uncomfortable doing so, the report by NHS Confederation says.
The report, published earlier this month in partnership with the LGBT Foundation, says patients can only request care from a same-sex staff memberr_ in limited circumstances, such as if they are having an intimate examination.
It states that when a patient requests an employee administering care to be a woman or a man, “the comfort of the staff member should be prioritised”.
Patients with dementia ‘should be challenged’

The report goes on to say that “the patient has no right to be told that the person treating them is trans or non-binary,” adding: “It would likely be discriminatory for the patient to refuse to be treated or cared for by a trans person, unless clear and evidenced clinical harm may result to the patient.”
Patients with dementia “should still be challenged” if they express discriminatory views about transgender staff, the 97-page guide states, while their relatives “may be removed from the premises” if they do the same.
But a non-binary medic can refuse to treat a patient, with the advice stating they “should not be forced to deliver care if this would cause undue distress or invalidate their lived experience of gender”.
It comes as the NHS published its first equality, diversion and inclusion (EDI) plan, which outlines that organisations are to include “diversity training on gender reassignment and sexual orientation” within mandatory training for healthcare workers."

They will let you die, and then say you deserved it. And management will support them

True story from about eight years ago.

DM, living in very sheltered housing had dementia. She was on a five minute repeat. She could be very offensive and had a loud voice, but this was tackled by putting those with memory issues on the same table for lunch. They would have the same arguments every day and then forget. She like many others there had a carer come in but her carer did not stay for lunch.

One carer happened to be transgender and was present at lunch times to help their client with their food. At five minute intervals my mother would say "look at that bloke in a dress. Can't tell whether he is a he or a she."

As a result the sheltered housing asked me to provide supervision for my mother at lunch times. I did not mind because her carer was happy to take on the extra hours and because my mother could afford it. There was the added advantage in that the carer was able to supervise conversation on the table, meaning fewer arguments and fewer people being on the receiving end of my mother's sharp tongue. I was a bit miffed though that this request was only made when a transgender person was on the receiving end and not before.

In my view the advice around dementia patients is uncaring. I spent ten years trying to support my mother and manage her behaviour. I lost count of the number of times people who were supposed to understand, would tell me off for her wandering, her failing to keep up with her physio programme or whatever. Rather than push things on me, I needed understanding. Interestingly DM was very rude to a gay member of staff, not like her as she was pretty open minded: I think others wound her up. He was very upset so I spoke to the same sheltered housing management about it. They were dismissive. He works with people with dementia. He knows what comes with the territory.

This is the document.

https://www.nhsconfed.org/system/files/2023-06/Leading-for-all-supporting-trans-non-binary-healthcare-staff_2023.pdf

Reading the introduction it seems that they consulted with some trans and non-binary NHS staff and published their wishlist as a guidance document.

Well if a patient wants to be discriminatory they can always pay for whomever they wish privately, and leave the NHS to us who need it and don't bring out bigotry into the surgery! What a total non-story.

I mean if it was a transman doctor, they would not even know. And have no right to know, unless they are concerned with an intimate exam or are an assault victim as the guidelines say.

Easy solution. Next?

This document implies that the patient is required to provide a validation service for the HCP's gender identity.

A non-binary person would not be prevented from administering care in this circumstance; however, the comfort of the staff member should be prioritised. If they feel safe fulfilling care and presenting in a particular gender towards said patient, this is acceptable, however they should not be forced to deliver care if this would cause undue distress or invalidate their lived experience of gender.

Someone needs to explain to them that patients are not service providers.

thank you! So it was the “LGBT Foundation” that perpetrated this (see introduction sign off.)

All these Stonewall-lite organisations are a bit of a pink and blue blur to me but I’m sure their name has come up in the context of other really dodgy stuff.

The NHS is not an institution that follows the science anymore. They follow ideologies. The taxpayer and service users are the public servicing the needs of the NHS.

Why would you refuse? I wouldn't. I don't believe that trans men are actually women, but do do believe that they can offer effective care in most roles. Why would I refuse to be treated?

Dr Shipman style.

Honestly if patients (who are the customers here) are expected to provide validation services to paid employees of the NHS the NHS deserves to fail.

God help anyone who can't afford healthcare, we'll be like the US, but the NHS is already excluding a very large % of the population if it's demanding patients disclose previous sexual assaults before they'll be treated. Beggars belief, total lack of understand of the law AND safeguarding.

Also, disagreeing with gender/sex debate isn't the same as hate crime against trans people. Live and let live.

We're really close to anyone who self IDs as a doctor being the same as a trained doctor because unless we all play along and pretend then we're not subservient enough.

The toddlers are in charge with their outrageous narcissistic demands but instead of saying a firm 'no' apparently too many paid managers think it's fine for an entire health service to revolve around the entitled demands of a few.

I'm GNC and agender as I don't believe in the gender religion, ergo I'm trans, ergo I'm going to try and get a job in the NHS so I can just refuse to do any work when anyone looks at me a bit funny.

What I don't understand is medical staff not standing up and opposing this nonsense. HCPs I know tend to be fairly grounded in reality.

I have no access to the NHS and their policy wants me dead, they are making the Autistic sterile in the hope they are treated as a superior being. This intersection will not end with this one group of medics and many already have a God complex. They want less patients along less work and still collect £ and status. What kind of low life wants to gain a gigantic ego from sick people? As someone above noted some medics are wind up merchants and they will love this.

I think a patient would actually have to be disadvantaged by this preposterous and probably illegal guidance before being able to sue. As I understand it, you have to prove a detriment and, until we have an actual hard case, we can't do anything.

I'm sure the Legal Feminist makes the point that discrimination law does not apply to private citizens (patients). It applies to organisations etc. Otherwise, we could be sued for not dating tw. Which, come to think of it, is what they'd like to be the case.

What I don't understand is medical staff not standing up and opposing this nonsense. HCPs I know tend to be fairly grounded in reality.

There are sadly plenty of HCPs who have drunk the Kool-Aid, but, in the case of Confed, they won't have many clinicians on their staff - both the staff and members will be mainly non-clinical managers.

But surely that is discrimination against the patient?

But trans men are biological women and I would be happy for them to do an intimate exam what I wouldn't want is a trans woman who is in fact a biological man

I want a well medic treating me, if you are at work dressed as Henry VIII and think you are head of the church of England, that you can decree who lives and dies based on beliefs, you are not fit for the job.

It should be simple. In any situation where you can reasonably request the sex of the person to be the same as your own, you should be able to refuse someone presenting as the gender but actually of different sex.

So

• having a chaperone for any exam
• having a smear test
• having a breast exam (which note they say it is women only, you'd be shocked if a transwoman was given that role)
• but also any other 'intimate' care

You also don't need to have been assaulted to wish to have same sex care. I have residual 'issues' after undergoing IVF.

@IWillTakeOnTheNHS exactly but a basic knowledge of human anatomy, biology & science is a requirement of the job so if a patient were to question their knowledge treatment can be refused? But the patient can't refuse the care?

Well clearly, this is all about you. How foolish of us to overlook this.

I agree in general, but the right to refuse must always be more absolute than the right to request. Many requests may be reasonable but not achievable. I used to locum in a GP practice that had no male doctors. We could not accommodate requests for a male GP, although it was perfectly reasonable for a patient to want one. But it would have been assault for any of us to touch a patient who did not consent to having a female GP.

Your chair to keyboard interface appears to be defective. Please restart.

Yes. A re-boot is in order.

Last month my mother died of cancer. I spent about a week mainly sitting by her hospital bed. She was semi-conscious for a lot of the time.

It was probably the most stressful time of my life. It would have been even more stressful if I’d been faced with hostile Progress Pride symbols, a man wanting to provide intimate care for her or stupid questions about her gender & pronouns.

As it was the nurses were absolutely wonderful & that stuff never came up.